Lee Jeeyeon, Kang Byeongju, Jung Jin Hyang, Kim Hye Jung, Kim Won Hwa, Yang Jung Dug, Lee Joon Seok, Chae Yee Soo, Lee Soo Jung, Lee In Hee, Park Ji-Young, Park Nora Jee-Young, Park Ho Yong
Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea.
Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea.
BMC Cancer. 2024 Dec 30;24(1):1588. doi: 10.1186/s12885-024-13175-9.
During breast cancer surgery, the use of dyes such as indigo carmine, methylene blue, or indocyanine green (ICG) for targeting axillary lymph nodes (ALNs) under ultrasound guidance can result in rapid diffusion, complicated tissue differentiation, and disruption of staining. LuminoMark™, a novel ICG-hyaluronic acid mixture, can provide real-time visualization and minimize dye spread, thereby ensuring a clear surgical field. The aim of our study was to evaluate the efficacy of LuminoMark™ for targeting ALNs in patients with breast cancer.
A total of 13 patients with breast cancer (mean age 56.5 years; 92.3% female) and suspicious ALNs underwent targeted axillary surgery (TAS) with activated charcoal and LuminoMark™ injected into the LNs in the surgical field. The clinicopathological variables of the patients and diagnostic performance were assessed. The LNs injected with LuminoMark™ were examined for consistency with sentinel LNs (SLNs) and non-SLNs, as well as with charcoal-tattooed LNs.
The identification of SLNs took approximately 15.6 min from the start of skin incision, and it required 25.6 and 17.7 min, for charcoal-tattooed and LuminoMark-illuminated LNs, respectively. The identification rate was 92.3% with charcoal and 100% with LuminoMark™. The concordance rate between LuminoMark™ illumination and SLNs was higher than that between charcoal tattooing and SLNs. The concordance rate between the two methods was 76.9% (n = 10). Three months after surgery, the charcoal tattoo remained visible on the skin; however, LuminoMark™ was not visible.
Although both methods demonstrated high detection rates, the rate was higher using LuminoMark™. As LuminoMark™ was administered directly into LNs, this improved the accuracy of identifying LNs.
在乳腺癌手术中，使用靛胭脂、亚甲蓝或吲哚菁绿（ICG）等染料在超声引导下靶向腋窝淋巴结（ALN）会导致染料快速扩散、组织分化复杂以及染色破坏。新型ICG-透明质酸混合物LuminoMark™可提供实时可视化并最大程度减少染料扩散，从而确保手术视野清晰。我们研究的目的是评估LuminoMark™在乳腺癌患者中靶向ALN的疗效。
共有13例乳腺癌患者（平均年龄56.5岁；92.3%为女性）及可疑ALN接受了靶向腋窝手术（TAS），术中将活性炭和LuminoMark™注入手术野中的淋巴结。评估患者的临床病理变量和诊断性能。检查注入LuminoMark™的淋巴结与前哨淋巴结（SLN）、非SLN以及炭标记淋巴结的一致性。
从皮肤切口开始，识别SLN大约需要15.6分钟，炭标记和LuminoMark™照亮的淋巴结分别需要25.6分钟和17.7分钟。活性炭识别率为92.3%，LuminoMark™为100%。LuminoMark™照亮与SLN之间的一致性率高于炭标记与SLN之间的一致性率。两种方法之间的一致性率为76.9%（n = 10）。术后三个月，皮肤上仍可见炭标记；然而，LuminoMark™不可见。
虽然两种方法均显示出高检出率，但使用LuminoMark™时检出率更高。由于LuminoMark™是直接注入淋巴结的，这提高了识别淋巴结的准确性。
